Acute Bronchitis in Adults
Medically reviewed by C. Fookes, BPharm. Last updated on May 24, 2019.
What Is Acute Bronchitis?
Acute bronchitis is an infection of the bronchi (large and medium-sized air tubes) in the lungs. The infection causes inflammation, swelling, and increased mucus production within the bronchi. Bronchitis is usually caused by the same viruses that cause a cold or the flu, although occasionally it may be caused by bacteria. Acute bronchitis may also be called a “chest cold”.
Common health questions about acute bronchitis include:
- Who is more likely to get acute bronchitis?
- What causes acute bronchitis?
- What are the symptoms of acute bronchitis?
- How is acute bronchitis diagnosed?
- Is bronchitis contagious?
- What is the difference between acute and chronic bronchitis?
- Is there any way to prevent bronchitis?
Who is more likely to get acute bronchitis?
Acute bronchitis is common, affecting up to 5% of adults every year. It can occur at any time of the year but is most common in the colder, winter months. Acute bronchitis is most frequently seen in infants, younger children, and seniors. People who smoke; who are exposed to second-hand smoke or excessive air pollution, dust or lung irritants; with other lung diseases such as asthma, lung cancer or COPD, or with certain heart conditions are also at higher risk of acute bronchitis.
Some people with weakened immune systems or other major health problems are more at risk of developing severe problems such as pneumonia or respiratory failure from acute bronchitis. These include:
- Young children
- The elderly
- People with pre-existing health conditions such as asthma, COPD, cancer, or diabetes
- People who have not been immunized for the flu, pneumonia and whooping cough.
What causes acute bronchitis?
85% to 95% of cases are caused by viruses, such as rhinovirus, adenovirus, influenza A and B, and parainfluenza virus.
Bacteria can cause bronchitis in people with underlying health problems or complicate a pre-existing viral case. Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Bordetella pertussis are most commonly involved.
What are the symptoms of acute bronchitis?
The most common symptom is a nagging, cough that is usually productive. In 50% of people, the cough lasts for less than three weeks, but in 25% it may persist for more than 1 month. The color of the sputum may be clear, yellow or green; however, this does not predict whether the infection is viral or bacterial. Sometimes the sputum may be tinged with blood. Acute bronchitis typically develops within a week of a cold or the flu.
Other symptoms may include:
- Chest tightness
- Shortness of breath
- Sore throat
- Nasal congestion
- Mild Fever (not common)
- Feeling tired
If your cough is accompanied by a high or prolonged fever, seek medical advice. A high fever may indicate a more serious bacterial infection, such as pneumonia, or a viral infection such as influenza. Older patients may present with a low-grade fever but still have pneumonia. It is important to have a doctor examine you for secondary bacterial pneumonia, which may require an antibiotic. If influenza is diagnosed within 48 hours of symptom onset, an antiviral treatment like oseltamivir (Tamiflu) or zanamivir (Relenza) may be recommended.
Acute bronchitis is temporary and usually does not cause any permanent breathing difficulties. On average, adults with acute bronchitis usually take two to three days off work.
How is acute bronchitis diagnosed?
A doctor will diagnose acute bronchitis based on your collection of symptoms and history of illness. He or she will take a history of your symptoms, listen to your lungs, perform a physical examination, check your vital signs, and may order a chest x-ray or blood work to look for signs of infection.
There are no specific signs or laboratory tests that are diagnostic. The most important condition to rule out is acute pneumonia.
Spirometry (tests that measure your lung function and how well you can inhale/exhale air) may be conducted in some people, particularly those with underlying respiratory conditions such as asthma or COPD.
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Is Bronchitis Contagious?
Because acute bronchitis is a complication of a viral infection, usually the common cold or the flu, acute bronchitis is considered contagious. These viruses easily spread from person to person, particularly during winter when people are usually in close proximity to each other.
However, patients with asthma or chronic bronchitis who develop acute bronchitis as a complication of their primary condition are less likely to be contagious.
What Is the Difference Between Acute Bronchitis and Chronic Bronchitis?
Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months.
Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Patients with chronic bronchitis can develop exacerbations of acute bronchitis.
How is acute bronchitis treated?
In 85% of people, acute bronchitis will resolve by itself within three to ten days, although the cough may persist for several weeks. Since most cases are viral, antibiotics are not usually necessary, or effective. However; medical treatment, antibiotics, and sometimes hospitalization may be necessary for people with a bacterial cause for their acute bronchitis, with certain pre-existing conditions, or who have developed pneumonia.
Other treatments may be used to relieve your symptoms, although these will not resolve underlying bronchitis any faster. Examples include:
- Oral and nasal decongestants such as phenylephrine, pseudoephedrine, and oxymetazoline: Decrease swelling and inflammation in the nasal passages, allowing mucus to drain and more air flow
- Cough expectorants, such as guaifenesin: these reduce the thickness or viscosity of secretions and increase mucus flow, allowing it to be coughed out more easily
- Mild pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to help relieve a sore throat or headache
- Bronchodilators (prescription) like ipratropium (Atrovent) to open up the airways to allow easier breathing. Inhaled beta-2 agonists, such as albuterol, may be considered if asthma is also present.
It is also good to rest and drink plenty of fluids. Some people may find a humidifier helps.
Cough suppressants (dextromethorphan, codeine, benzonatate) have generally not been shown to be helpful.
If you develop new symptoms or your cough worsens or is still present after 3 weeks, contact your physician again. In acute bronchitis, coughing and airway sensitivity can persist up to 4 to 5 weeks, even after other symptoms have improved; however, you may need further evaluation.
Is There Any Way to Prevent Bronchitis?
Since acute bronchitis typically occurs as a complication of the common cold or flu, some general prevention measures may help to prevent complications.
- To reduce your risk of catching a viral infection, wash your hands frequently with soap and water and use alcohol-based hand sanitizers.
- Avoid close contact with sick people.
- Avoid touching your eyes, nose, and mouth. Viruses are easily transferred from your hands these parts of your body.
- Get vaccinated against influenza (flu) virus every year in the early fall in the U.S. You may also consider vaccination against certain types of pneumonia as well as pertussis (whooping cough). Your pharmacist or doctor can help you determine if you are a candidate for these vaccines.
- Don’t smoke, and stay away from secondhand smoke, dust, pollution, or chemicals.
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